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Case Reports
. 2016 Jan-Mar;6(1):63-5.
doi: 10.4103/2229-516X.174019.

Primary pulmonary synovial sarcoma: A case report and review of literature

Affiliations
Case Reports

Primary pulmonary synovial sarcoma: A case report and review of literature

Debasis Bhattacharya et al. Int J Appl Basic Med Res. 2016 Jan-Mar.

Abstract

Primary pulmonary synovial sarcoma is a very rare, but highly aggressive tumor. Metastatic pulmonary sarcoma due to hematogenous dissemination is much more common. Hence why in any case of pulmonary sarcoma, whole body survey is necessary to exclude a primary tumor elsewhere. No clinical or radiological presentations are specific for pulmonary sarcoma hence; it is often confused with bronchogenic carcinoma. On the other hand, image-guided fine needle aspiration cytology (FNAC) is very much helpful in diagnosis of bronchogenic carcinoma, whereas, it may be inclusive in cases pulmonary sarcomas including primary synovial sarcoma, especially in cases of huge pulmonary masses. So why image-guided tru-cut core biopsy or open lung biopsy and their histopathological examination, supplemented by immunohistochemistry are preferable for the tissue diagnosis of pulmonary synovial sarcoma, although FNAC and immunocytochemistry may be used for the diagnosis. Surgical resection is treatment of choice, if it is not possible, palliative chemotherapy may be an option. Here, we report a rare case of primary synovial sarcoma which occupied almost whole of the right hemithorax in a 60-year-old male farmer.

Keywords: Histopathology; immunohistochemistry; lung; primary synovial sarcoma; surgical resection.

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Figures

Figure 1
Figure 1
Contrast-enhanced computed tomography scan of thorax showing huge right sided pleural based heterogeneous intraparenchymal mass occupying almost whole of the right hemithorax with contralateral shifting of the mediastinum
Figure 2
Figure 2
Photomicrograph of histopathology of computed tomography-guided tru-cut biopsy of right sided lung mass showing sarcomatoid malignant neoplasm (H and E, ×10 and ×40)
Figure 3
Figure 3
Photomicrograph of immunohistochemistry of computed tomography-guided tru-cut biopsy tissue showing (a) bcl-2 positivity, (b) Calretinin negativity, (c) CD34 negativity and (d) cytokeratin negativity of spindle-shaped tumor cells

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